Publication

Prognostic impact of systemic inflammatory diseases in elderly patients with congestive heart failure

Journal Paper/Review - Oct 15, 2013

Units
PubMed
Doi

Citation
Burkard T, Brunner-La Rocca H, Pfisterer M, Handschin R, Pittl U, Zaker R, Hack D, Follath F, Rickli H, Pfister O, TIME-CHF Investigators. Prognostic impact of systemic inflammatory diseases in elderly patients with congestive heart failure. QJM 2013; 107:131-8.
Type
Journal Paper/Review (English)
Journal
QJM 2013; 107
Publication Date
Oct 15, 2013
Issn Electronic
1460-2393
Pages
131-8
Brief description/objective

BACKGROUND AND AIMS
Inflammation is part of the pathophysiology of congestive heart failure (CHF). However, little is known about the impact of the presence of systemic inflammatory disease (SID), defined as inflammatory syndrome with constitutional symptoms and involvement of at least two organs as co-morbidity on the clinical course and prognosis of patients with CHF.

METHODS AND RESULTS
This is an analysis of all 622 patients included in TIME-CHF. After an 18 months follow-up, outcomes of patients with and without SID were compared. Primary endpoint was all-cause hospitalization free survival. Secondary endpoints were overall survival and CHF hospitalization free survival. At baseline, 38 patients had history of SID (6.1%). These patients had higher N-terminal pro brain natriuretic peptide and worse renal function than patients without SID. SID was a risk factor for adverse outcome [primary endpoint: hazard ratio (HR) = 1.73 (95% confidence interval: 1.18-2.55, P = 0.005); survival: HR = 2.60 (1.49-4.55, P = 0.001); CHF hospitalization free survival: HR = 2.3 (1.45-3.65, P < 0.001)]. In multivariate models, SID remained the strongest independent risk factor for survival and CHF hospitalization free survival.

CONCLUSION
In elderly patients with CHF, SID is independently accompanied with adverse outcome. Given the increasing prevalence of SID in the elderly population, these findings are clinically important for both risk stratification and patient management.